U
N
I
T
1
|
Driver's Name - Last FREEMAN |
First SHERYL |
Middle LYNN |
Suffix
|
City NORWALK |
State IA - Iowa, US |
Zip 50211 |
Driver's Age 62 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Female |
State IA - Iowa, US |
Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat |
Endorsements None |
Restrictions
B - Cor Lenses |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 3 - Urine |
Drug Test Given? 3 - Urine |
Citation Charge Code 3
|
Citation Charge 3
|
Citation Charge Code 4
|
Citation Charge 4
|
Seating Position 01 - Front: Left Side / Motorcycle Driver |
Injury Status 2 - Incapacitating |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 3 - Extricated by mechanical means |
Transported to: IOWA METHODIST |
Transported by: AIR AMBULANCE |
Insurance Co. Name
|
Year 2000 |
Make Mercury - MERC |
Model GRAND MARQUIS |
Style 4 DR |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 9 - Unknown |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 04 - Crossed centerline/median |
Second Event 22 - Vehicle in/from other roadway |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
|
Hazardous Materials Released?
|
U
N
I
T
2
|
Driver's Name - Last WORDEN |
First JOSHUA |
Middle CHARLES EUGENE |
Suffix
|
City NORWALK |
State IA - Iowa, US |
Zip 50211 |
Driver's Age 18 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat |
Endorsements None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 1 - None |
Drug Test Given? 1 - None |
Citation Charge Code 3
|
Citation Charge 3
|
Citation Charge Code 4
|
Citation Charge 4
|
Seating Position 01 - Front: Left Side / Motorcycle Driver |
Injury Status 2 - Incapacitating |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 3 - Extricated by mechanical means |
Transported to: MERCY MEDICAL CENTER-DSM |
Transported by: AIR AMBULANCE |
Insurance Co. Name
|
Year 1990 |
Make
|
Model CHEROKEE LAREDO |
Style SUV |
Approximate Cost to Repair or Replace 4000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 03 |
Traffic Controls 01 - No controls present |
Vehicle Config. 04 - Sport utility vehicle |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 22 - Vehicle in/from other roadway |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
|
Hazardous Materials Released?
|
ACCIDENT ENVIRONMENT |
ROADWAY CHARACTERISTICS Major Contributing Circumstances: |
WORKZONE RELATED? |
SEQUENCE OF EVENTS |
Location of First Harmful Event 1 - On Roadway |
Weather Conditions (up to two) 02 - Partly cloudy |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 22 - Vehicle in/from other roadway |
Manner of Crash/Collision 2 - Head-on |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last ROUNDS |
First TYLER |
Middle LEE |
Suffix
|
City
|
State
|
Zip Code
|
Age 18 |
Sex Male |
Unit No. 002 |
Seating Position 08 - Rear: Center |
Injury Status 2 - Incapacitating |
Occupant Protection 1 - None used |
Airbag Deployment 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 3 - Extricated by mechanical means |
Transported to: MERCY MEDICAL CENTER-DSM |
Transported by: NORWALK AMBULANCE |
NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last LETZE |
First JENNIFER |
Middle LYNN |
Suffix
|
City
|
State
|
Zip Code
|
Age 18 |
Sex Female |
Unit No. 002 |
Seating Position 03 - Front: Right Side |
Injury Status 1 - Fatal |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 3 - Extricated by mechanical means |
Transported to: NORWALK FIRE DEPARTMENT |
Transported by: NORWALK AMBULANCE |
NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT #1, DRIVEN BY FREEMAN, WAS SOUTHBOUND ON HIGHWAY 28 APPROXIMATELY 1/2 MI SOUTH OF THE HIGHWAY 5 BYPASS. UNIT #2, DRIVEN BY WORDEN, WAS NORTHBOUND ON HIGHWAY 28. UNIT #1 CROSSED THE RAISED MEDIAN, DROVE INTO THE NORTHBOUND LANES, AND STRUCK UNIT #2 HEAD-ON. BOTH VEHICLES CAME TO REST IN THE NORTHBOUND LANES. A PASSENGER IN UNIT #2, JENNIFER LETZE, DIED FROM INJURIES SUSTAINED DURING THE ACCIDENT. THE INVESTIGATION CONTINUES AND CHARGES ARE PENDING. |
|
Officer
STALLO |
Badge No. 488 |
Time Officer Notified of Accident 16:43 |
Time Officer Arrived At Scene 17:39 |
Name of Agency P02 |
Date of Report 8/18/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653